While most of the world’s resources are focused on Birdflu and SARS, a disease that has been smouldering at the edges of medicine may once again become a threat: Tuberculosis.

Two hundred years ago, TB was called “The White Plague”. With the increased population density in cities, it spread quickly. The poor were the main victims, but Victorian literature mirrored it’s presence, romanticizing the quiet deaths of beautiful, pale women who slowly and romantically died.

Actually the reality of TB death is a lot worse, with slow strangulation and shortness of breath, choking on blood, bone pain from TB in the spine, etc.

Back then, known TB cases were sent to specialized hospitals.

The discovery of Streptomycin and other drugs changed the tide. Now the germ could be killed, and good nutrition.

So when I worked in Africa thirty years ago, active cases were still sent to sanitariums for treatment, partly to ensure the drugs were taken, and partly to make sure the patients ate decent meals to improve their immune system, but mostly to stop the spread of the disease.

Yet more recently, cases I have diagnosed have merely been hospitalized in isolation for two or three weeks, until their germ level was lowered on treatment, and the treatment continued as an outpatient- often by nurses who visited their homes to give them treatment two or three times a week, to make sure they took the medicine correctly.

Now however drug resistant TB is reappearing, and is becoming a problem in South Africa. Part of the problem is HIV, which prevents the body’s defenses from helping the anti biotic kill all the germs.

So what do you do?

Let the people spread the disease, or force them into TB sanitariums.

I suspect that civil rights people will defend their right to be free and kill others with their disease.


Nancy Reyes is a retired physician who lives in the rural Philippines with her husband, six dogs, three cats, and a large extended family. Her webpage is Finest Kind Clinic and Fishmarket and she also writes medical articles at Tioedong’s Xanga site.

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